tbuckley/cabot-search huggingface dataset:
Characteristics and Treatment Rate of Patients With Hepatitis C Virus Infection in the Direct-Acting Antiviral Era and During the COVID-19 Pandemic in the United States
Authors: Vy H. Nguyen, Leslie Kam, Yee Hui Yeo, Daniel Q. Huang, Linda Henry, Ramsey Cheung, Mindie H. Nguyen
Journal: JAMA Network Open (2022)

Importance Clinical data on hepatitis C virus (HCV) treatment rates in the United States are sparse. Objective To evaluate HCV treatment rates in the era of direct-acting antivirals (DAAs). Design, Setting, and Participants This retrospective cohort study used data from the deidentified Optum Cliniformatics Data Mart Database (2014-2021) on patients with HCV in the DAA and COVID-19 eras. The database includes patients with private health insurance in the US. Main Outcomes and Measures The treatment rate and changes over time were assessed with adjusted log-binomial regression, and factors associated with treatment were examined using multivariable logistic regression. Results A total of 133 348 patients with HCV (79 567 [59.7%] men; mean [SD] age, 59.7 [12.3] years; 4448 [3.3%] Asian, 24 662 [18.5%] Black, and 74 750 [56.1%] White individuals) were included; 38 180 (26.8%) had HCV RNA data, and of those, 20 277 (53.1%) had positive HCV RNA. Overall, 13 214 patients with positive HCV RNA tests (65.2%) received DAA treatment; 6456 of 6634 patients treated with DAAs (97.3%) achieved sustained virologic response. After adjusting for age, sex, and race and ethnicity, the treatment rate in 2018 was 0.5 times greater than the rate in 2014 (adjusted prevalence ratio, 1.50; 95% CI, 1.42-1.59) but declined after 2018, decreasing from 64.8% to 61.2%, and especially after 2019, when it decreased to less than 60% ( P &amp;amp;lt; .001). The number of patients with viremic HCV identified in between April 2020 and March 2021 also decreased to 496 from 2761 and 3258 in the preceding 2 years. Receiving care from a gastroenterologist or infectious disease specialist with advanced care practitioner (ie, nurse practitioner, physician assistant, or clinical nurse specialist) was independently associated with greater odds of DAA treatment (adjusted odds ratio [aOR], 1.64; 95% CI, 1.07-1.50). Patients with decompensated cirrhosis and/or hepatocellular carcinoma (HCC) were 31% less likely to receive treatment compared with those without (aOR, 0.69; 95% CI, 0.54-0.90). Conclusions and Relevance In this cohort study, less than two-thirds of insured patients with viremic HCV received DAA treatment, with declines in both the treatment rate and the number of viremic HCV diagnoses since 2019 and especially during the COVID-19 pandemic. Further efforts are needed to increase HCV diagnosis and treatment, especially for those with cirrhosis and HCC. An urgent call for nationwide actions to improve access to DAA treatment, community outreach programs, and specialists through referral pipelines is needed in the United States to stay on track to meet the World Health Organization goal of reducing the burden of viral hepatitis with the eventual goal to eliminate viral hepatitis.
Effect of a Multicomponent Intervention Delivered on a Web-Based Platform on Hypertension Control
Authors: Haoqi Zhou, Xin Wang, Ying Yang, Zuo Chen, Linfeng Zhang, Congyi Zheng, Lan Shao, Ye Tian, Xue Cao, Zhen Hu, Yixin Tian, Lu Chen, Jiayin Cai, Runqing Gu, Zengwu Wang
Journal: JAMA Network Open (2022)

Importance The prevalence of hypertension is high and still increasing across the world, while the control rate remains low in many countries. Emerging technology, such as telemedicine, may offer additional support to change the unsatisfactory situation. Objective To establish a multicomponent intervention delivered on a web-based telemedicine platform and oriented with the Chinese hypertension management guidelines and to evaluate the effect of the intervention on blood pressure (BP) control for patients with hypertension. Design, Setting, and Participants This cluster randomized clinical trial of a hypertension management program was conducted at 66 community health centers in China from October 1, 2018, to May 31, 2020, with a 12-month follow-up. Patients with hypertension were blinded to randomization and were randomized to either the intervention group or control group. Hypertension was diagnosed at mean systolic BP (SBP) and diastolic BP (DBP) readings higher than 140 and 90 mm Hg or with use of antihypertensive medication. Evaluation of the intervention effect was based on the principle of modified intention to treat. Interventions Multicomponent intervention was delivered on a web-based platform and consisted of a primary prevention program for cardiovascular disease and standardized management for hypertension. Main Outcomes and Measures The primary outcome was the change in BP control rate (SBP and DBP levels &amp;amp;lt;140 and 90 mm Hg, or &amp;amp;lt;130 and 80 mm Hg for patients with diabetes) from baseline to the 12-month follow-up among patients with hypertension in the intervention and control groups. Results A total of 4118 patients (mean [SD] age, 61.6 [9.4] years; 2265 women [55.0%]) were included in the analysis, with 2985 in the intervention group and 1133 in the control group. The BP control rate at baseline was 22.8% in the intervention group and 22.5% in the control group. After 12 months of the intervention, the BP control rate for the intervention group compared with the control group was significantly higher (47.4% vs 30.2%; odds ratio, 1.18; 95% CI, 1.13-1.24; P &amp;amp;lt; .001). The intervention effect on SBP level was –10.1 mm Hg (95% CI, –11.7 to –8.5 mm Hg; P &amp;amp;lt; .001) and on DBP level was –1.8 mm Hg (95% CI, –2.8 to –0.8 mm Hg; P &amp;amp;lt; .001). Conclusions and Relevance Results of this trial showed that a multicomponent intervention delivered on a web-based platform improved BP control rate and lowered BP level more than usual care alone. Such a telemedicine program may provide a new, effective way to treat patients with hypertension in the community and may generate public health benefits across diverse populations. Trial Registration Chinese Clinical Trial Registry Identifier: ChiCTR1800017791
Federal Funding and Citation Metrics of US Biomedical Researchers, 1996 to 2022
Authors: John P. A. Ioannidis, Iztok Hozo, Benjamin Djulbegovic
Journal: JAMA Network Open (2022)

Importance Both citation and funding metrics converge in shaping current perceptions of academic success. Objective To evaluate what proportion of the most-cited US-based scientists are funded by biomedical federal agencies and whether funded scientists are more cited than nonfunded ones. Design, Setting, and Participants This survey study used linkage of a Scopus-based database on top-cited US researchers (according to a composite citation metric) and the National Institutes of Health RePORTER database of federal funding (33 biomedical federal agencies). Matching was based on name and institution. US-based top-cited scientists who were allocated to any of 69 scientific subfields highly related to biomedicine were considered in the main analysis. Data were downloaded on June 11, 2022. Main Outcomes and Measures Proportion of US-based top-cited biomedical scientists who had any (1996-2022), recent (2015-2022), and current (2021-2022) funding. Comparisons of funded and nonfunded scientists assessed total citations and a composite citation index. Results There were 204 603 records in RePORTER (1996-2022) and 75 316 US-based top-cited scientists in the career-long citation database; 40 887 scientists were included in the main analysis. The proportion of US-based top-cited biomedical scientists (according to career-long citation impact) who had received any federal funding from biomedical research agencies was 62.7% (25 650 of 40 887) for any funding (1996-2022), 23.1% (9427 of 40 887) for recent funding (2015-2022), and 14.1% (5778 of 40 887) for current funding (2021-2022). Respective proportions were 64.8%, 31.4%, and 20.9%, for top-cited scientists according to recent single-year citation impact. There was large variability across scientific subfields (eg, current funding: 31% of career-long impact top-cited scientists in geriatrics, 30% in bioinformatics and 29% in developmental biology, but 0% in legal and forensic medicine, general psychology and cognitive sciences, and gender studies). Funded top-cited researchers were overall more cited than nonfunded top-cited scientists (median [IQR], 9594 [5650-1703] vs 5352 [3057-9890] citations; P &amp;amp;lt; .001) and substantial difference remained after adjusting for subfield and years since first publication. Differences were more prominent in some specific biomedical subfields. Conclusions and Relevance In this survey study, biomedical federal funding had offered support to approximately two-thirds of the top-cited biomedical scientists at some point during the last quarter century, but only a small minority of top-cited scientists had current federal biomedical funding. The large unevenness across subfields needs to be addressed with ways that improve equity, efficiency, excellence, and translational potential.
Appropriateness of Initial Course of Action in the Management of Blunt Trauma Based on a Diagnostic Workup Including an Extended Ultrasonography Scan
Authors: Fanny Planquart, Emmanuel Marcaggi, Raiko Blondonnet, Olivier Clovet, Xavier Bobbia, Bastien Boussat, Julien Pottecher, Tobias Gauss, Laurent Zieleskiewicz, Pierre Bouzat
Journal: JAMA Network Open (2022)

Importance The extended Focused Assessment With Sonography for Trauma (E-FAST) has become a cornerstone of the diagnostic workup in patients with trauma. The added value of a diagnostic workup including an E-FAST to support decision-making remains unknown. Objective To determine how often an immediate course of action adopted in the resuscitation room based on a diagnostic workup that included an E-FAST and before whole-body computed tomography scanning (WBCT) in patients with blunt trauma was appropriate. Design, Setting, and Participants This cohort study was conducted at 6 French level I trauma centers between November 5, 2018, and November 5, 2019. Consecutive patients treated for blunt trauma were assessed at the participating centers. Data analysis took place in February 2022. Exposures Diagnostic workup associating E-FAST (including abdominal, thoracic, pubic, and transcranial Doppler ultrasonography scan), systematic clinical examination, and chest and pelvic radiographs. Main Outcomes and Measures The main outcome criterion was the appropriateness of the observed course of action (including abstention) in the resuscitation room according to evaluation by a masked expert panel. Results Of 515 patients screened, 510 patients (99.0%) were included. Among the 510 patients included, 394 were men (77.3%), the median (IQR) age was 46 years (29-61 years), and the median (IQR) Injury Severity Score (ISS) was 24 (17-34). Based on the initial diagnostic workup, no immediate therapeutic action was deemed necessary in 233 cases (45.7%). Conversely, the following immediate therapeutic actions were initiated before WBCT: 6 emergency laparotomies (1.2%), 2 pelvic angioembolisations (0.4%), 52 pelvic binders (10.2%), 41 chest drains (8.0%) and 16 chest decompressions (3.1%), 60 osmotherapies (11.8%), and 6 thoracotomies (1.2%). To improve cerebral blood flow based on transcranial doppler recordings, norepinephrine was initiated in 108 cases (21.2%). In summary, the expert panel considered the course of action appropriate in 493 of 510 cases (96.7%; 95% CI, 94.7%-98.0%). Among the 17 cases (3.3%) with inappropriate course of action, 13 (76%) corresponded to a deviation from existing guidelines and 4 (24%) resulted from an erroneous interpretation of the E-FAST. Conclusions and Relevance This prospective, multicenter cohort study found that a diagnostic resuscitation room workup for patients with blunt trauma that included E-FAST with clinical assessment and targeted chest and pelvic radiographs was associated with the determination of an appropriate course of action prior to WBCT.
Effect of Early High-Dose Recombinant Human Erythropoietin on Behavior and Quality of Life in Children Aged 5 Years Born Very Preterm
Authors: Eleonora Picotti, Tilman Reinelt, Brigitte Koller, Hans Ulrich Bucher, Christoph M. Rüegger, Jean-Claude Fauchère, Giancarlo Natalucci, Georg Zellinger, Sylviane Pasquier, Andrea Capone, Christoph Bührer, René Glanzmann, Sven Schulzke, Peter Weber, Brigitte Scharrer, Walter Bär, Elmar Keller, Christa Killer, Riccardo Pfister, Karin Krämer, Petra S Hüppi, Cristina Borradori-Tolsa, Beatrix Latal, Hans Ulrich Bucher, Jean-Claude Fauchère, Sven Welmann, Brigitte Koller, Giancarlo Natalucci
Journal: JAMA Network Open (2022)

Importance In light of the promising neuroprotective properties of recombinant human erythropoietin (RHEpo), the Swiss EPO Neuroprotection Trial was started to investigate its effect on neurodevelopment in very preterm infants. The results of the primary and secondary outcome analysis did not show any effect of RHEpo on cognitive performance, neuromotor outcomes, or somatic growth of the study participants at ages 2 or 5 years. Objective To investigate whether early high-dose RHEpo improves behavioral outcomes and health-related quality of life (HRQoL) at age 5 years. Design, Setting, and Participants This was a prespecified secondary analysis of the double-blind, placebo-controlled, multicenter Swiss EPO Neuroprotection randomized clinical trial, which was conducted at 5 level-III perinatal centers in Switzerland. Infants born between 26 weeks 0 days’ and 31 weeks 6 days’ gestation were recruited between 2005 and 2012 and followed-up until age 5 years (last follow-up in 2018). Data were analyzed from January 6 to December 31, 2021. Interventions Infants were assigned to receive either RHEpo (3000 IU/kg) or placebo (saline, 0.9%) intravenously 3 times within the first 42 hours after birth. Main Outcomes and Measures The prespecified parent-reported measures of behavioral outcomes and health-related quality of life (HRQoL) of their children at the age of 5 years were assessed by two standardized questionnaires: the Strengths and Difficulties Questionnaire (behavioral outcomes) and the KIDSCREEN-27 (HRQoL). Results Among 448 randomized infants, 228 infants were assigned to the RHEpo group and 220 infants were assigned to the placebo group. Questionnaire data were available for 317 children (71%) at a mean (SD) age of 5.8 (0.4) years (mean [SD] gestational age at birth, 29.3 [1.6] weeks; mean [SD] birth weight 1220 [340] grams; 128 [40%] female infants). At the age 5 years follow-up, the mean (SD) total difficulties score in the RHEpo group (8.41 [5.60] points) was similar to that of the placebo group (7.76 [4.81]) ( P = .37). There were no statistically significant differences between the groups in any other outcome measures. Conclusions and Relevance This secondary analysis of a randomized clinical trial showed no evidence for an effect of early high-dose RHEpo administration on behavioral outcomes or HRQoL in children born very preterm at early school age. Trial Registration ClinicalTrials.gov Identifier: NCT00413946
Fyn deficiency inhibits oxidative stress by decreasing c-Cbl-mediated ubiquitination of Sirt1 to attenuate diabetic renal fibrosis
Authors: Shanshan Li, Zeyuan Lin, Haiming Xiao, Zhanchi Xu, Chuting Li, Jingran Zeng, Xi Xie, Li Deng, Heqing Huang
Journal: Metabolism (2022)
Postoperative Adjuvant Hepatic Arterial Infusion Chemotherapy With FOLFOX in Hepatocellular Carcinoma With Microvascular Invasion: A Multicenter, Phase III, Randomized Study
Authors: Shao-Hua Li, Jie Mei, Yuan Cheng, Qiang Li, Qiao-Xuan Wang, Chong-Kai Fang, Qiu-Cheng Lei, Hua-Kun Huang, Ming-Rong Cao, Rui Luo, Jing-Duo Deng, Yu-Chuan Jiang, Rong-Ce Zhao, Liang-He Lu, Jing-Wen Zou, Min Deng, Wen-Ping Lin, Ren-Guo Guan, Yu-Hua Wen, Ji-Bin Li, Lie Zheng, Zhi-Xing Guo, Yi-Hong Ling, Huan-Wei Chen, Chong Zhong, Wei Wei, Rong-Ping Guo
Journal: Journal of Clinical Oncology (2022)

To report the efficacy and safety of postoperative adjuvant hepatic arterial infusion chemotherapy (HAIC) with 5-fluorouracil and oxaliplatin (FOLFOX) in hepatocellular carcinoma (HCC) patients with microvascular invasion (MVI).In this randomized, open-label, multicenter trial, histologically confirmed HCC patients with MVI were randomly assigned (1:1) to receive adjuvant FOLFOX-HAIC (treatment group) or routine follow-up (control group). The primary end point was disease-free survival (DFS) by intention-to-treat (ITT) analysis while secondary end points were overall survival, recurrence rate, and safety.Between June 2016 and August 2021, a total of 315 patients (ITT population) at five centers were randomly assigned to the treatment group (n = 157) or the control group (n = 158). In the ITT population, the median DFS was 20.3 months (95% CI, 10.4 to 30.3) in the treatment group versus 10.0 months (95% CI, 6.8 to 13.2) in the control group (hazard ratio, 0.59; 95% CI, 0.43 to 0.81; P = .001). The overall survival rates at 1 year, 2 years, and 3 years were 93.8% (95% CI, 89.8 to 98.1), 86.4% (95% CI, 80.0 to 93.2), and 80.4% (95% CI, 71.9 to 89.9) for the treatment group and 92.0% (95% CI, 87.6 to 96.7), 86.0% (95% CI, 79.9 to 92.6), and 74.9% (95% CI, 65.5 to 85.7) for the control group (hazard ratio, 0.64; 95% CI, 0.36 to 1.14; P = .130), respectively. The recurrence rates were 40.1% (63/157) in the treatment group and 55.7% (88/158) in the control group. Majority of the adverse events were grade 0-1 (83.8%), with no treatment-related death in both groups.Postoperative adjuvant HAIC with FOLFOX significantly improved the DFS benefits with acceptable toxicities in HCC patients with MVI.
IDH-mutant glioma: A new IDH1 inhibitor moves forward
Authors: Julie J Miller, Isabel Arrillaga-Romany
Journal: Neuro-Oncology (2022)

Journal Article IDH-mutant glioma: A new IDH1 inhibitor moves forward Get access Julie J Miller, Julie J Miller Stephen E. and Catherine Pappas Center for Neuro-Oncology Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA Corresponding Author: Julie J. Miller, M.D., Ph.D, Stephen E. and Catherine Pappas Center for Neuro-Oncology Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA (julie.miller@mgh.harvard.edu). https://orcid.org/0000-0002-1288-593X Search for other works by this author on: Oxford Academic PubMed Google Scholar Isabel Arrillaga-Romany Isabel Arrillaga-Romany Stephen E. and Catherine Pappas Center for Neuro-Oncology Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA https://orcid.org/0000-0001-5951-1225 Search for other works by this author on: Oxford Academic PubMed Google Scholar Neuro-Oncology, Volume 25, Issue 2, February 2023, Pages 337–338, https://doi.org/10.1093/neuonc/noac275 Published: 16 December 2022 Article history Published: 16 December 2022 Corrected and typeset: 09 January 2023
Survival in Young Adults With Cancer Is Associated With Medicaid Expansion Through the Affordable Care Act
Authors: Xu Ji, Kewei Sylvia Shi, Ann C. Mertens, Jingxuan Zhao, K. Robin Yabroff, Sharon M. Castellino, Xuesong Han
Journal: Journal of Clinical Oncology (2022)

Medicaid expansion through the Affordable Care Act (ACA) has been shown to improve insurance coverage and early diagnosis of cancer in young adults (YAs); whether these improvements translate to survival benefits remains unknown. We examined the association between Medicaid expansion under the ACA and 2-year overall survival among YAs with cancer.
Deciphering the role of platelets in severe allergy by an integrative omics approach
Authors: Carmela Pablo‐Torres, Elena Izquierdo, Tiak Ju Tan, David Obeso, Janice A. Layhadi, Javier Sánchez‐Solares, Leticia Mera‐Berriatua, José Luis Bueno‐Cabrera, María del Mar Reaño‐Martos, Alfredo Iglesias‐Cadarso, Coral Barbas, Cristina Gomez‐Casado, Alma Villaseñor, Domingo Barber, Mohamed H. Shamji, María M. Escribese
Journal: Allergy (2022)

Mechanisms causing the onset and perpetuation of inflammation in severe allergic patients remain unknown. Our previous studies suggested that severe allergic inflammation is linked to platelet dysfunction.Platelet-rich plasma (PRP) and platelet-poor plasma (PPP) samples were obtained by platelet-apheresis from severe (n = 7) and mild (n = 10) allergic patients and nonallergic subjects (n = 9) to perform platelet lipidomics by liquid chromatography coupled to mass spectrometry (LC-MS) and RNA-seq analysis. Significant metabolites and transcripts were used to identify compromised biological pathways in the severe phenotype. Platelet and inflammation-related proteins were quantified by Luminex.Platelets from severe allergic patients were characterized by high levels of ceramides, phosphoinositols, phosphocholines, and sphingomyelins. In contrast, they showed a decrease in eicosanoid precursor levels. Biological pathway analysis performed with the significant lipids revealed the alteration of phospholipases, calcium-dependent events, and linolenic metabolism. RNAseq confirmed mRNA overexpression of genes related to platelet activation and arachidonic acid metabolism in the severe phenotypes. Pathway analysis indicated the alteration of NOD, MAPK, TLR, TNF, and IL-17 pathways in the severe phenotype. P-Selectin and IL-17AF proteins were increased in the severe phenotype.This study demonstrates that platelet lipid, mRNA, and protein content is different according to allergy severity. These findings suggest that platelet load is a potential source of biomarkers and a new chance for therapeutic targets in severe inflammatory pathologies.
Has increased telehealth access during COVID-19 led to over-utilization of primary care?
Authors: Kaushik P. Venkatesh, Marium M. Raza, Joseph Kvedar
Journal: npj Digital Medicine (2022)

Telehealth use for primary care has skyrocketed since the onset of the COVID-19 pandemic. Enthusiasts have praised this new medium of delivery as a way to increase access to care while potentially reducing spending. Over two years into the pandemic, the question of whether telehealth will lead to an increase in primary care utilization and spending has been met with contradictory answers. Some evidence suggests that telehealth may be used as an addition to in-person visits. Others like Dixit et al. have found that telehealth can actually substitute for in-person care rather than contribute to overutilization. As telehealth continues to evolve, outcomes, utilization, and quality of care should be closely monitored.
Clinical Implications of APOBEC3-Mediated Mutagenesis in Breast Cancer
Authors: Pieter A. Roelofs, John W.M. Martens, Reuben S. Harris, Paul N. Span
Journal: Clinical Cancer Research (2022)

Abstract Over recent years, members of the APOBEC3 family of cytosine deaminases have been implicated in increased cancer genome mutagenesis, thereby contributing to intratumor and intertumor genomic heterogeneity and therapy resistance in, among others, breast cancer. Understanding the available methods for clinical detection of these enzymes, the conditions required for their (dysregulated) expression, the clinical impact they have, and the clinical implications they may offer is crucial in understanding the current impact of APOBEC3-mediated mutagenesis in breast cancer. Here, we provide a comprehensive review of recent developments in the detection of APOBEC3-mediated mutagenesis and responsible APOBEC3 enzymes, summarize the pathways that control their expression, and explore the clinical ramifications and opportunities they pose. We propose that APOBEC3-mediated mutagenesis can function as a helpful predictive biomarker in several standard-of-care breast cancer treatment plans and may be a novel target for treatment.